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born to one of the parties on or after the date of the marriage and are claimed to be children of the marriage. (List only children who have not yet reached the age of 23.)

(List only children who have not yet reached the age of 23.)

DIVORCE COMPLAINT (DISSOLUTION OF MARRIAGE) JD-FM-159 Rev. 3-17 C.G.S. §§ 46b-40, 46b-56c, 46b-84, P.B. § 25-2, et seq.

Name of child (First, Middle Initial, Last) Date of birth (Month, day, year)

5. ("X" all that apply)

6. A divorce is being sought because: ("X" all that apply)

"X" and complete all that apply for items 6-13. Attach additional sheets if needed.

Name of child (First, Middle Initial, Last) Date of birth (Month, day, year)

7.8. 9.

CROSS COMPLAINT CODE ONLY

CRSCMP

10.

STATE OF CONNECTICUT SUPERIOR COURT

www.jud.ct.gov

before the filing of this divorce complaint or before the divorce will become final.

then returned to Connecticut, planning to live here permanently.

3. b. Date of civil union that merged into marriage by subsequent ceremony or by operation of law

Complaint: Complete this form. Attach a completed Summons (JD-FM-3) and Notice of Automatic Court Orders (JD-FM-158).

Amended ComplaintCross Complaint: Complete this form and attach to the Answer (JD-FM-160) unless it is already filed.

plaintiff defendant

plaintiff defendant

The marriage broke down after plaintiff defendant

This marriage has broken down irretrievably.Other (must be reason(s) listed in section 46b-40(c) of the Connecticut General Statutes):

No children were born to either the plaintiff or defendant after the date of this marriage.There are no children of this marriage under the age of 23.The following children are either: (a) the biological and/or adoptive children of both of the parties, or (b) have been

The following children were born on or after the date of the marriage to the ("X" all that apply) plaintiff defendant

4. Town and State, or Country where marriage took place3. a. Date of marriage

Judicial District of At (Town) Return date (Month, day, year) Docket number

Plaintiff's name (Last, First, Middle Initial) Defendant's name (Last, First, Middle Initial)

1. Plaintiff's birth name (If different from above) 2. Defendant's birth name (If different from above)

ADA NOTICE The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA.

The ("X" one) has lived in Connecticut for at least 12 months immediately

The ("X" one) lived in Connecticut at the time of the marriage, moved away, and

the ("X" one) moved to Connecticut.

and are not children of the other party to this marriage.

JD-FM-159 Rev. 3-17 Page 2 of 2

any other documents filed with this Complaint to the City Clerk of the town providing assistance and file the Certification of Notice (JD-FM-175) with the court clerk.

The other parent of this unborn child is the

State of Connecticut:

If yes, you must send a copy of the Summons, Complaint, Notice of Automatic Court Orders and any other documents filed with this Complaint to the Assistant Attorney General, 55 Elm Street, Hartford, CT 06106, and file the Certification of Notice (JD-FM-175) with the court clerk.

The Court is asked to order: ("X" all that apply)

Signature

If there is a court order regarding custody or support for any child listed above, name the child(ren) below and specify the person or agency awarded custody or ordered to pay support:

And anything else the Court deems fair.

)

.

educational support of the child(ren).

• If this is a Complaint, attach a copy of the Automatic Court Orders before serving a copy on the Defendant.

• If this is an Amended Complaint or a Cross Complaint, you must mail or deliver a copy to anyone who has filed an appearance and you must complete the certification below.

13.

11.

12. The ("X" all that apply)

14.

parental decision-making regarding the minor child(ren).AND

The ("X" all that apply) from a city or town in Connecticut. ("X" one)

Regarding Parental Decision-making Responsibility:

Regarding Physical Custody:

schedule of physical care of the minor child(ren).

Child's name Name of person or agency awarded custody Name of person ordered to pay support

Child's name Name of person or agency awarded custody Name of person ordered to pay support

Child's name Name of person or agency awarded custody Name of person ordered to pay support

plaintiff defendant

financial support Yes No Do not knowHUSKY Health Insurance Yes No Do not know

plaintiff defendant(date)

plaintiff or defendant unknownnot the plaintiff not the defendant.

plaintiff defendantYes

No Do not know.

A divorce (dissolution of marriage).

A fair division of property and debts.

Alimony.

Child Support.

An order regarding the post-majority

Name change to:

Sole custody.Joint legal custody.A parenting responsibility plan which includes a plan for the

Primary residence with:Visitation.A parenting responsibility plan which includes a plan for the

Print name of person signing Date signed

Address Juris number (If applicable) Telephone (Area code first)

and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented parties receiving electronic delivery.

CertificationI certify that a copy of this document was mailed or delivered electronically or non-electronically on (date) to all attorneys

Name and address of each party and attorney that copy was mailed or delivered to*

Signed (Signature of filer)

u

*If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to.Print or type name of person signing Date signed

Telephone numberMailing address (Number, street, town, state and zip code)

or any of the child(ren) listed above have received from the

("X" one)("X" one)

The ("X" all that apply) is pregnant with a child due to be born on

or any of the child(ren) listed above has received financial support

If yes, send a copy of the Summons, Complaint, Notice of Automatic Court Orders and(City or town: